Pleural dedifferentiated liposarcoma: A case report

Abstract

The present case report describes a rare case of pleural liposarcoma. A 45-year-old Japanese man was hospitalized for increasing left chest pain. Imaging revealed a 10-cm pleural tumor and a 1.7-cm contralateral right pulmonary nodule. Biopsy specimens of the pleural tumor showed undifferentiated spindle-shaped and/or rounded sarcomatous features with myxoid stroma. The patient underwent embolization of the arteries feeding the left pleural tumor and palliative partial resection of the pleural tumor. The surgically removed specimens exhibited similar undifferentiated sarcomatous features. The left pleural tumor regrew aggressively, and the patient succumbed to mortality ~4.2 months following hospitalization. Autopsy demonstrated a 35-cm left pleural tumor, metastasizing to both adrenal glands and lumbar vertebral bones, and a 2.2-cm primary adenocarcinoma of the right lung. The majority of the left pleural tumor and its metastases consisted of undifferentiated sarcomatous elements, however, scattered or aggregated lipoblasts were identified in localized areas adjacent to the diaphragm. Immunohistochemically, these lipoblasts were diffusely positive for MDM2 and focally positive for S-100 protein. Undifferentiated sarcomatous tumor cells were focally positive for MDM2 but negative for S-100 protein. This case was diagnosed as pleural dedifferentiated liposarcoma. The local aggressiveness of the pleural liposarcoma directly contributed to the patient's mortality. A review of the literature indicated that the dedifferentiated subtype may serve as a factor that is indicative of a poor prognosis for pleural liposarcoma.

Complete Resection of a Cavoatrial Metastatic Liposarcoma under Hypothermic Circulatory Arrest

“…Liposarcomas commonly occur in the extremities, particularly in the thigh; however, primary pleural liposarcoma is very rare with very few reports of isolated cases. [1][2][3][4] Although the exact incidence of primary pleural liposarcoma is unknown, an intrathoracic origin liposarcoma comprises 2.7% of all liposarcoma cases and most liposarcomas in this region arise in the mediastinum. 5) In fact, Matsukuma et al conducted a literature review of primary pleural liposarcomas in 2019, reporting only 31 cases of primary pleural liposarcoma published from 1942 to 2018.…”

Primary retroperitoneal liposarcoma: a rare case report

“…13,14 In addition, pressure on the kidney may cause hydronephrosis, and pressure on the bladder may cause frequent urination and urgency. 15 Pressure into the chest from a large tumor may lead to breathing difficulties. 16…”

Complete resection of a cavoatrial metastatic dedifferentiated liposarcoma under hypothermic circulatory arrest

“…Liposarcomas commonly occur in the extremities, however, primary pleural liposarcoma is extremely rare with very few reported cases 1 . We could only find 34 reported cases of pleural liposarcomas [1][2][3][4] .…”

“…Although liposarcoma is a common soft tissue sarcoma, pleural liposarcoma has rarely been reported and its prognosis is poor due to higher incidences of metastasis and recurrence 1 . We report the case of a patient who underwent successful complete resection of a cavoatrial metastatic tumor originating from primary pleural liposarcoma using cardiopulmonary bypass (CPB) and hypothermic circulatory arrest (HCA).…”